National/international medical professionals working together at a clinic in Ormoc, Philippines – a model that is no longer allowed by the current WHO EMT guidelines. Photo Credit: Boaz Arad/IsraAID (2013)

In 2013, Typhoon Haiyan devastated the Philippines and galvanised the international community. Organisations, like the American Red Cross, sent full-scale field hospitals. Others, like IsraAID, despatched medical personnel and supplies, providing surge capacity to local clinics.

Integrating external resources into existing healthcare systems is an effective strategy, with potential long-term benefits. Yet, while such activities may be a model for integrating disaster risk reduction into response, World Health Organization (WHO) guidelines do not permit them.

The WHO classification system was created to counter the variation “in capacities, competencies and adherence to professional ethics” amongst Emergency Medical Teams (EMTs). Each of the three approved EMT types must operate independently and be self-sufficient for 2–4 weeks. This emphasis on independence avoids ‘burdening’ affected populations, but it leaves no room for interventions to support national/local healthcare institutions.

In fact, the WHO’s 91-page document outlining EMT minimum standards contains no reference to existing healthcare systems, let alone strategies for cooperation. This omission perpetuates the myth that ‘helpless’ disaster-affected people need international organisations to ‘save them’, instead of recognising that disaster response is often locally driven. Further, EMTs acting alone face avoidable linguistic, cultural, and logistic obstacles that hamper the quality of care provided. Setting up alternative healthcare locations, pathways, and practices may also sow confusion, thus increasing long-term vulnerability by undermining trust in the healthcare system.

Efforts to standardise EMTs and rout out malpractice and disaster tourism are welcome. But the WHO guidelines sadly disregard successful integrated models, like IsraAID’s, instead promoting foreign intervention over local capacity and prevention. If only the WHO abided by their own Health Emergency and Disaster Risk Management framework.